Mount Sinai ADRC (Sano): Biomarker Core (Core G) ? Research Summary Biomarkers provide indirect evidence of the pathological hallmarks of Alzheimer's disease (AD), affording earlier diagnosis of AD and increased likelihood that individuals enrolled in therapeutic trials targeting these pathologies will benefit from the intervention. Biomarker research is increasingly necessary for enabling bidirectional translational efforts, for understanding heterogeneity of the disease, and for identifying resilience factors. The proposed Biomarker Core will consolidate and bolster existing efforts involving biomarker research with the goals of improving early diagnosis, identifying indicators of resilience, characterization of disease heterogeneity, and acceleration of clinical trial efforts. The aims of the Biomarker Core are to: 1) Provide services for biomarker collection and analysis on the ADRC cohort and to facilitate ADRD research broadly. The Core will coordinate biomarker characterization of the ADRC cohort using the NIH-AA research framework (A/T/N). The Core will provide recommendations for acquisition with specific MRI sequences, PET tracers, and fluid biomarkers; analytic pipelines; and expertise to support project design. 2) Promote wide and rapid sharing through interactions with other Cores, across the institution, and with outside institutions. The Core will facilitate informatics for banking and sharing processed neuroimaging data and fluid samples, help to route biomarker- characterized participants to best-matched studies and trials, and support a culture of open science to encourage collaborative efforts across institutional boundaries. 3) Leverage imaging biomarker data to catalyze development of innovative projects focused on biomarkers as early indicators of disease risk and to characterize heterogeneity and resilience factors. The Core will actively work with investigators to optimize inclusion of biomarkers in projects and will provide access to biomarker-characterized participants. 4) Develop the future through biomarker training and involvement in project-based activities. The Core will provide biomarker training to REC trainees and to investigators new to ADRD research, consult with investigators to develop projects involving biomarkers, and will link clinical ADRD researchers to technical expertise in biomarkers. Across these aims, the Core will emphasize the early stages of disease (preclinical and mild cognitive impairment), with a goal of maximizing utility to existing observational projects and increasing the likelihood that characterized participants will remain in the sample for enrollment into clinical trials. The Core will prioritize characterization of under- represented minorities to contribute to health disparities research and increase the generalizability of ADRD biomarker research. These Core activities will support acquisition, analysis, informatics, and data sharing to integrate biomarker research into the efforts of the ADRC to accelerate understanding of disease hetereogeneity by illuminating biological differences associated with vulnerability or resilience factors that underlie the expression of clinical symptoms.